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Evaluation of Esophago‐gastric Varices with Endoscopic Ultrasonography
Author(s) -
URABE Takeshi,
YONESHIMA Manabu,
OIKO Yoshiyasu,
INAGAKI Yutaka,
KANEKO Shuichi,
UNOURA Masashi,
KOBAYASHI Kenichi
Publication year - 1990
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1990.tb00073.x
Subject(s) - medicine , varices , esophagus , radiology , gastric varices , endoscopic ultrasonography , sclerotherapy , esophageal varices , portal hypertension , endoscopy , gastroenterology , cirrhosis
Esophago‐gastric varices of 22 patients were studied using a newly developed method of endoscopic ultrasonography (EUS). During the observation, the esophagus was filled with de‐aerated water, and reflux of the water was prevented using a balloon placed 7 cm proximal to the tip of the endoscope. Thirteen of 22 patients received endoscopic sclerotherapy (EIS) for their esophago‐gastric varices, and sequential changes of the varices were observed mith EUS. The EUS method demonstrated esophago‐gastric varices as singular, or a bundle of low‐echoic luminal structures, and extramural collateral vessels were also observed. Therefore, it was possible to evaluate the residual blood flow after EIS by the EUS findings. Sequential changes of the treated varices were observed as follows: (1) formation of a thrombus in the varices, (2) thickening of variceal wall, and (3) disappearance of luminal structures. Small luminal structures in the extramural space of the lower esophagus, dilated paraesophageal veins, were detected in 6 of 13 patients with EIS. The recurrence rate was smaller and the remission period was longer in these 6 patients than those in patients without these luminal structures. Our new EUS method has been shown to be useful not only for the morphological evaluation of varices, but also for the assessment of the effect of EIS.